Pernicious Anaemia Society
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Could it be low B12 again?

Background info: 20, F, 167cm, ~65kg, citalopram 40mg for anxiety and Clenil modulite 2x daily for asthma, Nexplanon implant, non-smoker, occasional alcohol, vegetarian, previous low ferritin and B12

Hello PAS - this is my first post here so I'm sorry if it's a bit rambly! I have a question about optimal b12 levels and a kind Reddit user directed me to this forum to ask it ☺

I had a ferritin level of 23 and a low b12 level last November (can't remember the exact result) and I'm feeling the exact same way again (persistent fatigue, brain fog, low exercise endurance, all-over aches, restless legs at night, slight tingling in hands and feet, patches of dry skin around eyes, hair loss, occasional dizziness and vertical ridges on nails). I had them checked was in March and they were 37 and 270 respectively, so my gp said to stop taking supplements.

Got some iron supplements and stupidly started taking them before having a blood test and my ferritin level was 45. Everything on the CBC was 'within range' (but some figures were on the low end of normal, namely white blood cells, MCV and MCH) but they didn't check the b12 like I asked them to!

Do I go back and ask the gp to check my b12 as I'm still feeling bleh and it's really affecting my uni work? Or will the iron tablets I took skew the results for a while yet?

I feel like I'm being fobbed off with the 'it's just your anxiety/OCD' explanation as soon as someone sees I'm on citalopram but as far as I'm aware, my OCD does not cause weird dry skin or aching knees, neither does it make me fall asleep during seminars -_- .

I'd be grateful for any help and advice!

Thanks ☺

6 Replies
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Hi, it's likely that the B12 supplements you took will still be showing in your blood tests. The usual advice is to not take anything for 3 months to be clear of it, I think. However, if you found that the B12 tablets you took were helpful, you could take them again. You can't overdose on B12! However, lots of people on here can't absorb B12 and need injections rather than tablets - tablets still raise blood serum levels, but can't necessarily be used. As you're veggie, it might be that you can absorb, and you're just not getting enough B12 from your diet, but it might also be that you have enough in your diet (particularly if you eat dairy) and just don't absorb it well. You could try taking some B12 info from the pinned posts on here back to your GP?

Good luck, hope you feel better soon x

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Hi spacey1,

Thanks so much for replying so quickly!

I eat loads of dairy which is why I was surprised that I had low b12 last year... It's been nearly three months since my last b12 blood test so I don't know if the 1000 microgram cyanocobalamin tablets I was prescribed will stop skewing the results. Should I give it another month and see if things get worse?

Thanks ☺

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Depends on how bad you feel! It might be helpful so you can get a true picture from a blood test, but if you're feeling really horrible, you may need to get some B12 into your system faster. Will your GP agree to do the loading injections to see if they help?

You are right, OCD and anxiety cause all kinds of symptoms, but they don't cause tiredness and brain fog, or achey knees! :)

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I might compromise and give it a couple of weeks. I'm always worried about wasting the doctor's time if the blood tests are fine :/ but I do keep getting more and more tingling sensations in my hands at night so I guess that's reason enough to go.

I don't know about the loading injections.. I didn't have them before, in fact it was just one of those pills every 3 days, but maybe I'll ask about them! I'm in Germany at the moment and I think their B12 deficiency cut-off is a bit higher than in the UK, so hopefully they'll take me seriously!

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I'm not sure of the protocol in Germany, but in the UK GPs are supposed to go on symptoms more than blood levels. They often don't, though!

Pills are great for people who just aren't getting B12 in their diet, but for a non-absorber, they're not usually helpful.

Could you try another GP in the practice?

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Yeah I'm changing practice bc the previous one didn't even test the B12 itself, just a CBC!

Thanks for all your advice so far - I'm feeling so much calmer now ☺ now they just need to work out if my levels were/are low due to not enough intake or absorption issues...

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